Whipps Cross Hospital, a large, busy multi-service hospital with a rapidly growing local population faced a challenge with their estate which predominantly predated the creation of the NHS. The proposed redevelopment offered a once-in-a-generation opportunity to reconsider how care is delivered, both in terms of the care models offered and the facilities used.

Whipps Cross Hospital is a large, busy district general hospital in North East London. It provides a range of healthcare services including a 24/7 A&E, a consultant-led maternity unit and a trauma unit. The local area has one of the fastest-growing populations in the UK. Much of the estate predates the creation of the NHS and the quality of the estate is starting to have a negative impact on patient care. We focused on a six-step process to redevelop the hospital:

Phase 1: Developing a health and care services strategy

The first phase of our work focused on developing a health and care services strategy across both the hospital and the wider system supported by substantial clinical engagement. This was supported by detailed demand and capacity analysis in order to accurately size the future hospital-based upon opportunities to improve care in and out of the hospital. The first phase consisted of the following:

Development of a Health and Care Services Strategy

  • Mapped detailed clinical pathways at the speciality level
  • Developed enabling requirements for the delivery of the new models of care

Demand and capacity analysis

  • Developed clear do-nothing trajectories for each type of activity
  • Modelled opportunities to reduce activity to give final capacity required

Cross-functional engagement

  • Engaged over 200 clinical, managerial and operational staff from the hospital, trust, CCG, council and primary care
  • Conducted 42 interactive workshops to develop detailed models of care

Phase 2: Converting the strategy and analysis into a hospital size

The second phase of the project focused on converting the health and care services strategy and demand analysis into a hospital size. Operational policies define how each department in the new hospital will run and were developed in conjunction with healthcare professionals and operational staff within the hospital. This, when combined with the demand analysis, allowed the development of a schedule of accommodation to size the hospital. Development of a co-adjacencies matrix and bubble diagram will support the conversion of the schedule of accommodation into detailed hospitals plans. The second phase consisted of the following:

Operational Policies

  • Written operational policies detailing how each department in the redeveloped hospital will run
  • Operational policy tables detailing numerical assumptions for each department e.g. operating hours assumed length of intervention

Schedule of accommodation

  • Summary schedule of accommodation detailing whole hospital sizing
  • Room-by-room schedule detailing the full make-up of the hospital


  • Whole hospital bubble diagram provided an easy method to engage stakeholders in co-adjacencies
  • Detailed adjacency matrix to support whole hospital development